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USAN JOAOIJIN COUNTY PIJB1,I( ;AT,TH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 F.WEBER AVE.-3RD FLOOR <br /> STOCKTON <br /> <br /> AR0O16333 <br /> Facility ID FA00O9333o <br /> Date Printed 2/28/01 <br /> 0 <br /> LARRY DEJONG RE : C DEJONG TRUCKING INC <br /> C DEJONG TRUCKING INC 24975 S AUSTIN RD <br /> PO BOX 126 RIPON CA 95366 20 <br /> RIPON CA 95366 OWNER: C DEJONG TRUCKING INC <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0079812---Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total forth Invoice $110.00 <br /> Payment Due Date 01 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to : PHS/EHD / Return a Copy of This STATEMENT with Your PAYM <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAYMEN] <br /> RECEIVED <br /> MAR 14 2001 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH OIVISIUN <br /> 5255.rpt <br />